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Early conversion to below-elbow cast for non-reduced diaphyseal both-bone forearm fractures in children is safe: preliminary results of a multicentre randomised controlled trial

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

This multicentre randomised controlled trial was designed to explore whether 6 weeks above-elbow cast (AEC) or 3 weeks AEC followed by 3 weeks below-elbow cast (BEC) cause similar limitation of pronation and supination in non-reduced diaphyseal both-bone forearm fractures in children.

Materials and methods

Children were randomly allocated to 6 weeks AEC or to 3 weeks AEC followed by 3 weeks BEC. The primary outcome was limitation of pronation and supination after 6 months. The secondary outcomes were re-displacement of the fracture, complication rate, limitation of flexion and extension of wrist and elbow, cast comfort, cosmetics, complaints in daily life and assessment of radiographs.

Results

A group of 23 children was treated with 6 weeks AEC and 24 children with 3 weeks AEC and 3 weeks BEC. The follow-up rate was 98 % with a mean follow-up of 7.0 months. The mean limitation of pronation and supination was 23.3 ± 22.0 for children treated with AEC and 18.0 ± 16.9 for children treated with AEC and BEC. The other study outcomes were similar in both groups.

Conclusions

Early conversion to BEC is safe in the treatment of non-reduced diaphyseal both-bone forearm fractures in children.

Level of evidence

Multicentre randomised controlled trial, Level II.

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Acknowledgments

The corresponding author received a grant of 10,800 Euros from the Anna Foundation, the Netherlands. The Anna Foundation had no role in study design, data collection, data analysis, data interpretation, writing of the report, or decision to submit the paper for publication. The corresponding author had full access to all the data and had final responsibility for the decision to submit for publication.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Erasmus Medical Center, Westzeedijk 361, Postbus 2040, 3000 CA, Rotterdam, The Netherlands

    Joost W. Colaris, Max Reijman & Jan A. N. Verhaar

  2. Department of Surgery, HAGA Hospital, The Hague, The Netherlands

    Jan Hein Allema

  3. Department of Surgery, Sint Franciscus Hospital, Rotterdam, The Netherlands

    L. Ulas Biter & Albert J. H. Kerver

  4. Department of Orthopaedic Surgery, Reinier de Graaf Hospital, Delft, The Netherlands

    Rolf M. Bloem

  5. Department of Paediatric Surgery, Erasmus Medical Center, Rotterdam, The Netherlands

    Cees P. van de Ven

  6. Department of Surgery, Reinier de Graaf Hospital, Delft, The Netherlands

    Mark R. de Vries

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  1. Joost W. Colaris
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Correspondence to Joost W. Colaris.

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Colaris, J.W., Reijman, M., Allema, J.H. et al. Early conversion to below-elbow cast for non-reduced diaphyseal both-bone forearm fractures in children is safe: preliminary results of a multicentre randomised controlled trial. Arch Orthop Trauma Surg 133, 1407–1414 (2013). https://doi.org/10.1007/s00402-013-1812-8

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  • DOI: https://doi.org/10.1007/s00402-013-1812-8

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